Monday, August 22, 2011

In Loco Parentis

Last week's post about the sleepy undergrad inspired some comments that suggested (with varying levels of vehemence) that the professor involved should intervene in some way and facilitate medical treatment of a possibly serious condition. [In fact, based on additional information, I can say with some certainty that the student was just tired after a long night with little sleep.]

In any case, like many of you, every year/term I receive information from my university about how to recognize warning signs of a troubled student; for example, a student suffering from depression, or a potentially dangerous student. There is information about counseling centers and other resources to help students with mental and physical problems.

Although these e-mails and brochures contain a lot of information, of course they can't cover every possible situations. Sometimes, you just have to make a guess as to whether there is a problem, and if so, whether it is a severe one and whether you can/should do anything about it.

I have colleagues who have walked with a student to the health center when the student was in obvious need of immediate attention for a mental or physical problem and was willing to seek treatment. Of course it's harder to know what to do in more ambiguous situations, or in cases in which the student denies a problem, or is even upset or belligerent at the suggestion of a problem.

Consider the case I described on Friday: an undergraduate fell asleep during a meeting in a professor's office, while the professor was explaining something to the student about the student's research project. The professor asked the student a few questions to see if there was a problem (fainting? illness? etc.); the student said everything was fine, s/he wasn't ill.

Clearly some commenters felt that the professor should have done more. Would you have done more? If the student said "I'm fine", would you drop the subject or would you pursue it?

Poll time!

In the scenario relevant to this poll, imagine a student who is not obviously ill or injured. They fall asleep at an unexpected time, and then claim to be fine. End of discussion or just the beginning?

What would you do?

Drop the subject immediately.

Pursue the subject a bit more, asking a few more questions.

Pursue the subject until the student is convinced to seek medical attention.

21 comments:

Anonymous
said...

Intervention in situations like this always seems like the right thing to 'should-have-been-done' after the fact (when a student does turn out to be ill, or hurt himself). However, this is college/university, not high school. Students are to be treated like adults. (And should behave accordingly...)

Professors should steer away from the in loco parentis thing. I've found that those who take a deep interest in the health and/or emotional goings on of their students quickly cross the line into creepily invasive. That and they only give the help and care to some students (the attractive ones, the loud ones) and not others...It's not good.

That said, it's just creepy to continue a meeting when the person across from you is passing out before your eyes. Especially if that person is a subordinate and therefore unlikely to speak up and ask for a break or a reschedule. Instead of compounding things with invasive, patronising questions, how about just saying, "Look, let's take a five minute break."

It could be that the student had a hard shift waitressing the night before, or was up all night finishing a paper, or had a terrible break-up, or has a drinking problem, or struggles with insomnia. Why is any of that the professor's business?

I spend time in the field with my students, far from medical facilities, and would not let something like this go. Seeing a student fall asleep during a conversation would be an immediate red flag. I realize not every faculty member has this same concern, but discovering narcolepsy or another serious problem could save the student's life in a more dangerous situation.

(Although, depending upon which professor the student had the unfortunate sleeping incident with, I suppose *that* could have been dangerous, too?)

I would make a note of the student's behavior (mental and/or recording it on the info sheets I collect from students at the beginning of the semester), and if the student's behavior (i.e. falling asleep in a one-on-one) re-occurs, then I might press more to see if there is an underlying issue. However, since I am NOT a trained psychiatrist or MD, I definitely do not want to rush into judgement.

I choose hidden option (d): pay particular attention to that student for a while, to see if additional instances of odd behavior emerge.

E.g., falling asleep inappropriately once, I would not worry too much (and assume that the student's bogus-sounding explanation was to cover up something common like insufficient sleep). But if it happened one or two more times, then I might take action.

All you people with undiagnosed narcolepsy or other sleep disorders: don't you have friends and family? Why rely on a professor to be the one to convince you to seek medical attention? I am asking seriously. Is it because they aren't so close to you (like family/friends who might miss something and just think that's the way you are) but yet who interact with you, perhaps on a daily basis?

I must admit that I don't think it is a professor's responsibility, but sure, if a professor notices something possibly problematic, they should (carefully) ask some questions. I would ask, but drop it quickly if the student didn't want to talk about it with me. However much I care about the health and well-being of my students, it crosses a lone for me to probe too much into their health issues if there are no obvious alarms.

I'm another vote for what I think is the common sense option: if it happens once, check that they're okay, if they say they are, drop the issue. If this becomes a recurring issue, go through the proper channels to make sure there is not a more serious problem going on... A single data point means nothing.

I am the professor in the story, and I can add that the student felt extremely embarrassed by the situation, swearing that it was the first time this had ever happened (I am not sure how to take that..). So I made sure she was fine, asked her how she was feeling (dizzy, weak, etc.). She kept saying "I am so sorry, I am so sorry, this is so embarrassing,.." that doing anything more would have made her very uncomfortable.

I have met with the student since, and she has been totally fine. She is an athlete and the captain of her college team; for those concerned with the student's health, there are no other indications that her falling asleep while listening to me was a sign of deeper medical troubles.

All you people with undiagnosed narcolepsy or other sleep disorders: don't you have friends and family?Well, actually, as a student it may very well be the case that you do not have friends and family around you. And the only people who have regular contact with you are your professors.But I think that the reaction to the original post was not "you must parent your students!" but merely nitpickers (like me) pointing out that since a young adult falling asleep in unusual situation is the very definition of narcolepsy, it is a bit incongruent to state with certainty that narcolepsy was ruled out in this case.

To be clear, I was only saying that the student might consider getting tested, not that the prof ought to intervene (what's the prof going to do anyway, schedule an appointment for the student?). For all I know, the student, or some other person who is mysteriously falling asleep, reads this blog.

I largely oppose in loco parentis (though I don't consider asking someone who passed out in front of you whether they're okay/need any help to be in loco parentis - I would do that for my boss, or a stranger; it's not implying a parental role).

These are not small kids. Ask a couple of questions and then drop it unless the answers are troubling (as in, yes, this happens a lot) in which case, I'd suggest they either get organized and prioritize (if they are overworked) or get help (if they don't know why at all). I don't think it's our responsibility much more than that.

Haha, my PI became in loco parentis for our lab's postdoc last year. The postdoc went out for a smoke break, had a seizure (with no prior history) and became unconscious. Someone called an ambulance, and the only emergency contact he had listed with the university was our lab. So the ER called the lab and my boss had to go down and make decisions.

Meanwhile we grad students scrambled to find someone to take responsibility for him! He was not from the US, lived alone and even ransacking his office didn't yield any information about his family. We vaguely remembered that his mother was a university math professor in his home country, and eventually found her by googling the post-doc's last name (in another alphabet, of course!) and figured out how to contact her.

Fortunately he came around about 48 hours later, and by the time we reached his mom, he was conscious. Anyway, moral of the story: make sure everyone in your lab has an emergency contact who isn't you!

As a manager in industry if one of my employees had fallen asleep during a meeting, I would be concerned about the person’s physical health, their state of mind, any recent upheavals in their personal life and the level of their interest in their work. My job includes looking after my team members. Why should it be any different in academia? Yes, students are adults not children, but as a supervisor you have the responsibility for your team to be in top form.

I would perhaps ask the student if everything is OK, but nothing more. In my country professors leave us alone in this respect, unless it seems to be something really serious, like suicide.

I was diagnosed with hypothyroidism last year. I was terribly tired and slept 16 hours a day. I surely would have graduated sooner if the doctors would have found out earlier that I have hypothyroidism. Well, in the end I got my master's degree despite of being a total wreck.

Now I have medication for the condition and I'm feeling a lot better. I am sure that I will feel even better in the future when the situation with the medicine stabilizes.

For the commenter who asked about friends and family: I only fall asleep in lecture classes. Sorry! I don't fall asleep in conversation with friends or family, or in labs. You may therefore label it a moral failing, but I call it something on the edge of normal and pathological that only occurs in certain environments (just like some mice can be prompted to overeat in certain environments).

Since my parents never lectured for 50 minutes in a non-emotionally-charged environment, they just didn't see it. My friends threw stuff at me in class -- does that count?

I was that student back in the day. I was working nights and sleeping days - unfortunately other things happen during the day too, so I was perpetually sleepy. Not only have I fallen asleep during conversations, I once fell asleep while walking and having a conversation.

Sometimes students are overextended and need to figure out the limitations of a 24-hour day. That doesn't mean there's anything medically wrong with them, or anything a professor can really do, other than offering them a chance to collect themselves.

"Meanwhile we grad students scrambled to find someone to take responsibility for him! He was not from the US, lived alone and even ransacking his office didn't yield any information about his family."

Am I the only one horrified by this? It's not "in loco parentis" to keep record of someone's emergency contacts--it's just decency and common sense.

This person travels from another country to work for low pay in a lab and the PI can't even be bothered to get some basic details about his next of kin or emergency contact? Really? So while he's in the hospital his apartment gets ransacked, and then his poor mom gets a random phone call at her work: "Yeah, your son's been unconscious in a hospital for two days."

WTF? Way to give a damn about your staff. If that's the environment he had to work in, no wonder he had a damn seizure.

In this case, the fact that one person is a professor is pretty much irrelevant. They are both human beings and as such they have a mutual responsibility towards each other. If *anyone* I knew was falling asleep at strange times, I would be concerned and would suggest rather strongly that they seek medical help.

Once, when I was an undergrad, my PI caught me about to fall asleep in the dishrack and sent me home. It was finals time. I hadn't slept in the past 24 hours and was a walking hazard. Of course, I didn't actually take the nap that was recommended; instead I studied and lamented the money I wasn't going to be making because I'd been sent home, but the point is, my PI notice I was not my usual self, sent me home, and probably saved the lab some broken glassware and me some broken skin by assuring me the dishes could wait until my finals were finished. We're all adults blah blah blah but when someone's putting themselves and/or their colleagues in danger or is just not able to do their job the group's leader has to step in. Also, if someone is clearly falling apart in front of you, it's sort of just plain polite and civil to ask them if they need help, no matter who they are. The buck can always be passed later.

What's tricky are the subtler, less-acute sorts of issues, like a suspected substance abuse problem or a slide into mental illness. Once again, if someone's behavior is creating a hazardous environment, or if they're not getting their job done, a good leader must step in, but if the person is compensating, where is the line?

My current PI (I'm a post-doc now) will occasionally ask if I'm happy but I strongly suspect that's boss code for "I'm not going to find an empty desk and tidy stack of lab notebooks in the office tomorrow, right?"

About Me

I am a full professor in a physical sciences field at a large research university. I am married and have a teenaged daughter.
I have the greatest job in the world, but this will not stop me from noting some of the more puzzling and stressful aspects of my career as a science professor.
E-mail (can't promise to reply): femalescienceprofessor@gmail.com